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    Managing Leukemia Treatment Side Effects

    Leukemia treatments destroy cancer cells. But these potentially life-saving treatments can be hard on your body, causing side effects. Everyone responds to cancer treatments differently. Your cancer care team can offer suggestions or make medication changes to manage treatment side effects so you feel better and enjoy a better quality of life.

    In a special webinar (right), Deborah A. Katz, MD, an assistant professor of medicine in the section of hematology at Rush University Medical Center in Chicago, provides tips on how to manage common side effects during treatment.

    What are common side effects of leukemia treatments?

    Side effects of leukemia treatments vary from person to person and with the type of treatment. The following tips can help ease leukemia treatment side effects including:

    • Fatigue
    • Hair loss
    • Infertility
    • Memory and concentration issues (“chemo brain”)
    • Nausea and vomiting
    • Nerve pain and weakness (chemotherapy-induced peripheral neuropathy)
    • Poor appetite

    Fatigue

    Extreme fatigue — the kind of exhaustion that doesn’t improve even with lots of rest — occurs with most leukemia treatments. For some people, fatigue lasts months or years after treatments end.

    Tips for managing fatigue:

    • Move a little more. Physical activity may sound impossible. Yet studies show that staying active during cancer treatments (like a short walk around the block) can be energizing. You can also try yoga, which may help you sleep more soundly at night.
    • Take rest breaks. Taking several short breaks during the day can revive you. But don’t nap for more than 30 minutes — it could affect your ability to fall asleep at night.
    • Ask for help. Enlist the aid of loved ones for tiring tasks like grocery shopping, house cleaning, and meal preparation.

    Hair loss

    Hair loss is a common side effect of chemotherapy, a standard treatment for many types of leukemia and blood cancers. Other treatments, like radiation therapy, can also make hair dry and brittle, causing it to fall out. Some people start to regrow hair while still getting treatments. For others, hair loss is permanent.

    Tips for managing hair loss:

    • Wear cooling caps. Cooling the scalp (scalp hypothermia) with a cooling cap or ice packs before, during, and after chemo treatments may prevent or reduce hair loss. The cold temperatures cause blood vessels in your scalp to narrow, reducing the amount of damaging chemo drugs that reach hair follicle cells.
    • Embrace a new look. Hair typically starts to fall out within one to three weeks of starting chemotherapy. Some people choose to cut their hair short or shave their locks to prevent the shock of seeing strands in the shower, on the sink, or on pillows.
    • Consider head coverings. Wigs, hats, and scarves can help you feel less self-conscious about your appearance while keeping your scalp warm and protected.

    Infertility

    Chemotherapy, radiation therapy, stem cell transplants, and other treatments can affect fertility. Other treatment side effects like fatigue, hair loss, and nausea also can diminish sexual desire. Adults of child-bearing age who plan to start or add to their families should meet with a fertility preservation specialist before starting leukemia treatments (when possible). This expert can also provide information to families whose children have leukemia.

    Tips for managing infertility:

    • See a fertility specialist. Some cancer centers have specialized oncofertility (cancer and fertility) programs. If your center doesn’t, ask your cancer care team for a referral to a fertility preservation center.
    • Know your options. Sperm banking, as well as egg and embryo freezing, may help you conceive when cancer treatments end. Some adults, as well as children, may benefit from an experimental process for freezing ovarian or testicular tissue.
    • Talk to a mental health professional. It can be overwhelming to cope with a cancer diagnosis, treatment side effects, and the potential loss of fertility. A mental health counselor can help you cope with stress, depression, or anxiety.

    Memory and concentration issues (chemo brain)

    Confusion, memory loss, and concentration issues are so common with chemotherapy that doctors refer to these side effects as “chemo brain.” You may become forgetful, struggle to complete tasks, or experience disorganized thinking. Most memory issues improve when treatment ends.

    Tips for managing chemo brain:

    • Tap into technology. Use smartphone apps and calendars to keep track of appointments, to-dos, and other important information. Synch this information on all electronic devices so the information is always available.
    • Exercise your brain and body. Keep your mind sharp by doing daily crossword puzzles or other problem-solving games. Physical activity like walking sends oxygenated blood to your brain to help you think clearer.
    • Get organized. Try to follow the same schedule every day, stash keys and other important objects in the same location, and focus on doing one task at a time instead of multitasking.

    Nausea and vomiting

    Immunotherapy and targeted therapy drugs, as well as chemotherapy and radiation therapy, can make you feel nauseous or sick to your stomach. Some people throw up. You may also feel dizzy, have a racing heart, or salivate more. Nausea and vomiting can affect your appetite, lead to dehydration, and worsen fatigue.

    Tips for managing nausea and vomiting:

    • Keep food in your belly. Nausea is often worse on an empty stomach. It helps to eat small snacks and sip cold liquids like water or tea throughout the day.
    • Be bland. If smells trigger nausea or vomiting, eat bland foods like crackers and toast. Eating cold or room-temperature foods also minimizes aromas. Avoid foods that are fried, fatty, or overly sweet or spicy.
    • Rest after eating. Sit upright (don’t lie down) for about an hour after eating to allow the food to start moving through your digestive tract.

    Nerve pain and weakness (chemotherapy-induced peripheral neuropathy)

    Treatments like chemotherapy can damage the peripheral nerves that help control movements and sensations. Chemotherapy-induced peripheral neuropathy (CIPN) causes symptoms like painful burning or tingling sensations and muscle numbness, weakness, or cramping.

    Tips for managing chemotherapy-induced peripheral neuropathy (CIPN):

    • Protect your body. Avoid things that worsen CIPN, such as extremely hot and cold temperatures and tight-fitting clothes and shoes. Wear gloves to protect your hands when outside and shoes or slippers to protect your feet when inside.
    • Show yourself grace. Give yourself adequate time to get to where you want to go or complete tasks. Be patient, don’t rush, and don’t be shy about asking loved ones for help.
    • Work with a therapist. An occupational therapist can teach you simpler ways to complete daily activities like getting dressed or brushing your teeth. A physical therapist can show you how to perform exercises to maintain mobility and strength safely.

    Poor appetite

    Many treatments, including chemotherapy, immunotherapy, and targeted therapy, can affect your appetite. Some treatments change how things smell or taste. You may also develop mouth sores that make it painful to eat. A nutritious diet is vital to helping your body stay strong to fight cancer and infections.

    Tips for managing a poor appetite:

    • Change your eating habits. To ensure you’re getting enough nutrients and calories, eat several smaller meals and snacks throughout the day instead of three big meals.
    • Cut back on fluids. To prevent filling up on liquids and not foods, take small sips of water or other beverages when you eat.
    • Soothe a sore mouth. If you have mouth sores or a sore throat, choose chilled foods like frozen yogurt or smoothies, avoid acidic foods and drinks, and sip through a straw.

    Treatment resources for you and your loved ones

    Support can make a significant difference when you need leukemia treatments. Check out our directory of resources, including treatment-specific webinars, for patients, families, and caregivers.

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